Michael Kang, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE60567455 Issued in WA

Practice address

509 Olive Way
Suite 1633
Seattle, WA 98101

Phone

(206) 624-8313

Fax

(206) 624-8922

NPI assigned

Sep 7, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 8, 2016 through Nov 8, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michael Kang, DMD, MMSC, PLLC

  • Dental Clinic/Center
  • Seattle, WA
  • NPI 1013376110
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1992054787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "SUITE 1633",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98101",
            "telephone_number": "206-624-8313",
            "fax_number": "206-624-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "SUITE 1633",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98101",
            "telephone_number": "206-624-8313",
            "fax_number": "206-624-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-07",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856135",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60567455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSURE",
            "identifier": "DN1856135",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DENTAL LICENSE",
            "identifier": "DE60567455",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Heayoung Kang, MS,CMC
• Ji Emily Kang
• Ji Won Kang, DMD
• John Kang, MD, PHD
• Kylie Haemin Kang, MD
• Michelle Kang
• Minjung Kang, N.D.
• Nancy Kang, ARNP
• Rachael Heyoung Kang, PHARMD
• Robin Kang, MD

• Endodontics in Seattle, WA
• Providers in Seattle, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.